Maryland health officials, alarmed by what they say are persistent patient care problems and substandard living conditions at a Bethesda nursing home, are considering taking the unprecedented step of asking a court to replace the facility's current managers, according to sources.

Officials in the state Department of Health and Mental Hygiene have scheduled a news conference for Tuesday to announce the latest in a series of actions against the management of the Bethesda Health Center, a 170-patient facility on Grosvenor Lane that has been cited several times for violating nursing care regulations since its opening in 1979.

"Things certainly are not up to snuff there," said Robert T. Carty, a Montgomery County health official whose inspectors have reported many health care violations at the nursing home in recent years.

Government sources said state health officials may invoke a 1982 Maryland law next week and ask a court to place the Bethesda Health Center in receivership, an action that they said has never been taken against any of the state's 200 nursing homes.

Placing the nursing home in receivership would turn over the day-to-day management of the facility to a party connected with neither the current managers nor the state government.

Several sources said health officials also are considering revoking the nursing home's operating license next week. Since the facility opened six years ago, the state has refused to renew its operating license once and has banned admissions there three times in three years, once because of "life-threatening" conditions found at the facility. During that period, however, the state allowed the facility to remain open.

Any action by the state would come on the heels of at least 10 inspections of the nursing home earlier this year that showed violations of maintenance, sanitation, dietary and nursing care standards, according to health officials and an attorney for David J. Becker, the nursing home owner.

"There are no life-threatening conditions whatsoever," said David R. Knoll, Becker's attorney. "The violations that were found were nitpicking. The state of Maryland is unhappy with Mr. Becker and wants him out of the state." Knoll added that the state criticized Becker, whose primary residence is in Buffalo, for being an "absentee administrator."

Becker said he and his staff were "correcting and modifying any known deficiencies." He declined further comment.

Maryland and Montgomery County officials said the violations found between March and June of this year were similar to those found in the summer of 1982, prompting the state to place the nursing home on a two-year probation that required Becker to step down as the center's administrator.

In the 1982 inspections, state and county investigators found more than 100 violations of state and federal nursing home regulations, according to state records.

Inspectors also reported a "disproportionately high" number of patient falls in the summer of 1982.

Becker and his lawyers said at the time that nearly all of the violations were caused by a staff shortage, not negligence.